What drugs might affect besides your mood

All meds carry risks, and those that treat emotional issues are no exception. But don't let fear stop you from getting help. "Not everyone experiences side effects," says Carlos A. Zarate, M.D., chief experimental therapeutics of the Mood and Anxiety Disorders Program at the National Institute of Mental Health in Bethesda, Maryland. "It's essential to work with your docs to tailor your treatment." Below, some common concerns.

"What if my meds make me gain weight?"

The reality

Unfortunately, many antidepressants and antipsychotics can cause weight gain, including antipsychotics such as Zyprexa, among others, which are often used to treat bipolar disorder, according to Dr. Zarate. Some research has shown that certain types can lead to especially rapid weight gain and metabolic shifts that can increase the risk for diabetes. The exact reason for this effect isn't known, but one theory is that the drugs impair satiety centers in the brain, causing increased appetite.

How to handle it

Patients who gain weight in the first week of treatment are most apt to keep gaining. "If that's the case for you and diet and exercise aren't working, ask your doctor about trying a drug that has not been linked to weight gain, such as Wellbutrin," Dr. Zarate says.

Keep in mind that if you're gaining weight, the drug may not be to blame. "When mood improves, some people also find that appetite does, too," Dr. Zarate says. Work with your doc to develop a healthy eating and exercise plan.

"What if I lose my sex drive?"

The reality

"A third to more than half of people on a class of antidepressants known as selective serotonin reuptake inhibitors are likely to have some sexual side effects," says Donald Rosen, M.D., associate professor of psychiatry at Oregon Health & Science University School of Medicine in Portland. SSRIs such as Zoloft and Prozac raise levels of the mood-lifting brain chemical serotonin. Some experts suggest that this shift may lead to a drop in dopamine, one of the brain's pleasure chemicals, possibly resulting in a dampening of sexual desire.

How to handle it

Talk to your doc about the state of your sex life before you start treatment. "Less interest in sex is also a symptom of depression. The meds may not be to blame," Dr. Rosen says.

Try a new scrip. "Antidepressants that don't target the brain's serotonin pathways do not appear to have a negative impact on sex drive," Dr. Rosen explains.

"Ask your doc about taking a brief holiday from the drug," Dr. Rosen says. Skipping meds from Friday to Sunday may help give your libido a lift for the weekend.

"What if I get addicted?"

The reality

Certain antianxiety Rx, such as Xanax and Klonopin, along with some sleeping pills and drugs used for attention deficit hyperactivity disorder, have been linked to dependency. "It is possible to develop a psychological or physical dependence?you feel as if you must have them to stay calm or to sleep," says Gary Small, M.D., professor of psychiatry and biobehavioral sciences at the University of California at Los Angeles. People may also get hooked on the euphoria from the stimulants in ADHD drugs. As for antidepressants, there is no evidence that they are addictive.

How to handle it

"The smaller your dose, the less likely it is that you'll experience dependency, so ask your doctor if you can start at the minimum effective dosage," Dr. Small says.

If you stop taking your medication abruptly, you may experience withdrawal symptoms such as headaches, irritability or gastrointestinal problems. "Before going off any prescription drug, be sure to talk to your doctor so you can develop a plan together for tapering off your treatment," Dr. Small says.

"What if I end up feeling devoid of all emotions?"

The reality

"Many patients do worry that their treatment will prevent them from experiencing vivid emotions or suppress their creativity," Dr. Rosen acknowledges. "It's difficult to know if these kinds of issues are genuine or due to the placebo effect, but there are times when my patients describe feeling as if there is a veil between themselves and their emotions."

How to handle it

"Many side effects, including emotional ones, are transient and pass within a few weeks," Dr. Rosen says. If you feel as if you're in a fog after that, consult your M.D.

"Tracking your moods and symptoms in a notebook, including emotional changes like irritability or difficulty sleeping, can be helpful," Dr. Zarate says. Dr. Rosen adds, "The point is not to blunt your feelings. Describe what you're feeling so your doctor can find an alternative."